Anabolic Steroid Use Grows, Legal or Not

By CAITLIN LIU

Published: August 3, 1996

Whenever the Olympic Games take the world stage, accusations about the use of performance-enhancing drugs are sure to follow. This time, pointed fingers and knowing nudges have been directed at various athletes, including Eastern European athletes, five of whom tested positive for a stimulant and were disqualified from competing in the Games.

Perhaps the accusations come so easily because the illegitimate use of such controlled substances, banned in competitions, has become so common. Although no one in the Summer Olympics has so far tested positive for anabolic steroids, which are used to enhance muscle-building, they have been the drugs of choice for athletes such as bodybuilders, runners and football players in the last two decades. Indeed, the drugs are big business.

In 1991, after mounting evidence of the drugs' ability to stunt adolescents' growth and perhaps touch off psychotic and violent behavior, anabolic steroids, which are synthetic derivatives of male sex hormones, were placed on the Federal list of controlled substances. Illicit sales of the drugs are punishable by as much as five years in prison.

Before 1991, about 50 percent of steroid users obtained the drugs through medical professionals, the Drug Enforcement Administration has said. The drugs are legally used to treat some diseases.

But virtually all current abusers obtain the substance from the black market. And the black market is huge: An estimated 500,000 Americans, mostly young, white and male, spend a total of $400 million a year on the synthetic steroid hormones. Far from seeking a chemical high, they ingest or inject the drug to build up their biceps and puff up their pectorals to improve their prowess in sports -- or just to show off their brawn.

At the same time, a quiet revolution is under way in the much smaller but booming legal market for the drug. IMS America, a company in Totowa, N.J., that compiles information on the health care industry, estimated that $36.7 million worth of anabolic steroids were sold through prescriptions or administered in hospitals last year. In just the first five months of this year, IMS America calculated, sales have swelled by 38.5 percent compared with the corresponding period last year.

But it is the vastly larger black market for the drug that is creating such a brouhaha in the sports world.

Law enforcement authorities say most of the illegal supply is smuggled into the United States from Europe and Mexico, where the drugs can be purchased over the counter. They are sold on the street in this country for anywhere from $1 to $10 a pill and $10 to $15 for one cubic centimeter of injectable liquid. Bodybuilders often ''stack'' the drug -- that is, take enormous and frequent doses that can cost them $1,000 a month and more.

But it is their use by athletes out to cheat their competitors that makes the headlines. Last year, two 14-year-old girls, Liza de Villiers, a sprinter from South Africa, and Jessica Foschi, a swimmer from the United States, tested positive for anabolic steroids at separate competitions and were banned from competition temporarily.

While steroids are usually associated with professional athletes or ordinary guys afflicted with an excess of bicep-envy, they do have legitimate applications, doctors say.

The principal legal use is the treatment of testosterone deficiencies that result from accidents, diseases or aging, Dr. Gary I. Wadler, a professor of medicine at New York University and a fellow at the American College of Sport Medicine, said.

Anabolic steroids are also sometimes used to treat patients in late stages of breast cancer, said Dr. Don H. Catlin, a professor of medicine and pharmacology at the University of California at Los Angeles and the director of the U.C.L.A. Olympic Analytical Laboratory, which conducts steroid testing for Olympic athletes.

Legal sales have gotten a lift from the introduction of skin patches that unlike either injections or pills deliver a steady flow of the chemical into the body. In 1994, the Alza Corporation introduced its Testoderm patch and within a year had grabbed nearly 20 percent of the new market. Androderm, a rival product introduced by SmithKline Beecham P.L.C. last November, almost immediately catapulted the company to the front of the pack, with almost 26 percent of the market for the first five months of this year, dropping Alza back to just under 17 percent.

Other major producers of anabolic steroids in the United States are ICN Pharmaceuticals and Pharmacia & Upjohn Inc., with about 23 percent and 18 percent of the market, respectively, IMS America said. Depending on the treatment, a month's supply of prescription steroids can cost anywhere from $30 to $170.

The medical community is currently debating other uses for the substance, which some specialists say might work as a male contraceptive and others believe has a therapeutic effect on AIDS patients.

Paradoxically, the drugs that can transform an average male into a latter-day Hercules can also diminish his virility. When men take anabolic steroids, they stop producing sperm, Dr. Catlin said. Their testicles shrink, and breasts become enlarged.